Background: The treatment of moderate-to-severe psoriasis has advanced significantly with the use of biologic treatments. Objective: To compare the effectiveness, safety, and impact on quality of life of biologic therapies versus conventional systemic therapies for moderate-to-severe psoriasis, using evidence from 2015 to 2025, focusing on the implications for understudied regions such as Iraq and the Middle East. Methods: Data was collected using "Embase," "MEDLINE," "PubMed," and "Cochrane Central Register." The study includes 45 randomized controlled trials. Additionally, 25 key real-world evidence studies were included for qualitative synthesis to provide context on long-term drug survival, quality of life, and regional applicability. Efficacy was assessed using Psoriasis Area Severity Index (PASI) 75, 90, and 100 response rates at both short-term (10-16 weeks) and long-term (44-60 weeks) intervals. Statistical analyses included Bayesian network meta-analysis and hierarchical cluster analysis. Results: Biological therapies, specifically IL-17 and IL-23 inhibitors, outperformed conventional therapy. In real-world research, 59.7% of patients on secukinumab attained PASI 90 at 3 months, compared to 18.8% with traditional systemics (p<0.001). Biologics also demonstrated a faster time to response (3.04 vs. 6.12 days), increased treatment survival rates, and better quality of life. Safety profiles were favorable, with class-specific hazards (e.g., infections, candidiasis) managed by screening. Conclusions: Biological treatments represent an improved therapy approach for moderate-to-severe psoriasis, providing more rapid, effective, and long-term clearance with a manageable safety profile. These findings call for revisiting traditional first-line therapy strategies, particularly in countries like those in the Middle East, where local data is lacking.
Objective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day
... Show MoreAn energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
... Show MoreThe purpose of this research shed light on the analysis of the relationship between the knowledge gap and the strategic performance gap and diagnose the level of impact this relationship in building a learning organization, and sought search to achieve a number of goals, cognitive and Applied been tested nature of the relationship and effect between variables in a sample size (62) of the managers of banks civil in Baghdad (Baghdad, Gulf, Assyria, Union, Elaf) and focused research problem in question is bold is whether the analysis of the relationship between the knowledge gap and the performance gap strategic leads to recognize organizations need to shift to organizations educated, either in the side of the field was the pr
... Show MoreThe study aims to identify the mechanical and electrical activities of the heart according to the energy systems of advanced players and to detect the differences between the energy systems in terms of the mechanical and electrical activities of the heart for advanced players. It was clear from the results of the significance of the differences between the three groups according to the energy systems of the advanced players in all research variables that (the non-oxygenic system "Lactic"), which represents the advanced players in the arches (800 m, 1500 m) was the first in most tests of mechanical and electrical activities of the heart, which is (Margaria-Kalamen, Wingate, systolic muscle strength of the heart FC, Stroke Volume SV
... Show MoreThis article investigates Iraq wars presentation in literature and media. The first section investigates the case of the returnees from the war and their experience, their trauma and final presentation of that experience. The article also investigates how trauma and fear is depicted to create an optimized image and state of fear that could in turn show Iraqi society as a traumatized society. Critics such as Suzie Grogan believes that the concept of trauma could expand to influence societies rather than one individual after exposure to trauma of being involved in wars and different major conflicts. This is reflected in Iraq as a country that was subjected to six comprehensive conflicts in its recent history, i.e. less than half a century; th
... Show MoreCharacterization of the heterogonous reservoir is complex representation and evaluation of petrophysical properties and application of the relationships between porosity-permeability within the framework of hydraulic flow units is used to estimate permeability in un-cored wells. Techniques of flow unit or hydraulic flow unit (HFU) divided the reservoir into zones laterally and vertically which can be managed and control fluid flow within flow unit and considerably is entirely different with other flow units through reservoir. Each flow unit can be distinguished by applying the relationships of flow zone indicator (FZI) method. Supporting the relationship between porosity and permeability by using flow zone indictor is ca
... Show MoreThis paper introduces a non-conventional approach with multi-dimensional random sampling to solve a cocaine abuse model with statistical probability. The mean Latin hypercube finite difference (MLHFD) method is proposed for the first time via hybrid integration of the classical numerical finite difference (FD) formula with Latin hypercube sampling (LHS) technique to create a random distribution for the model parameters which are dependent on time [Formula: see text]. The LHS technique gives advantage to MLHFD method to produce fast variation of the parameters’ values via number of multidimensional simulations (100, 1000 and 5000). The generated Latin hypercube sample which is random or non-deterministic in nature is further integ
... Show MoreThis paper aims at studying the illocutionary speech acts: direct and indirect to show the most dominant ones in a presidential speech delivered by the USA president. The speech is about the most critical health issue in the world, COVID-19 outbreak. A descriptive qualitative study was conducted by observing the first speech delivered by president Trump concerning coronavirus outbreak and surveying the illocutionary acts: directive, declarative, commissive, expressive, and representative. Searle's (1985) classification of illocutionary speech acts is adopted in the analysis.
What are the main types of the illocutionary speech acts performed by Trump in his speech?; Why does
... Show MoreBackground: Osteoarthritis is a chronic pathology of the joints causing disability and morbidity. Diacerein is a disease-modifying agent indicated for osteoarthritis management with enhanced performance and have much lower side effects profile than conventional non-steroidal anti-inflammatory drugs. Oral administration of Diacerein is associated with a laxative effect, thus causing treatment discontinuation. Aim: This study aimed to evaluate the activity of Diacerein novasome-based transdermal gel compared with standard oral treatment in the management of induced osteoarthritis in a rat model. Materials and methods: A single intra-articular injection of monosodium iodoacetate was administered to the left knee joint, resulting in the develop
... Show More